PHARM - Drugs Affecting the Respiratory System: Asthma - Week 7 Flashcards

1
Q

Define athsma.

A

A heterogenous disease of chronic airway inflammation

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2
Q

List 4 symptoms of athsma.

A

Wheezing
Breathlessness
Chest tightness
Cough

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3
Q

What is the prognosis of athsma like?

A

Generally good with proper management and treatment compliance

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4
Q

Give three host factors that influence the development of athsma.

A

Genetics
Gender (females more)
Obesity

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5
Q

Name 6 possible environmental factors that can influence athsma development.

A
Indoor allergens
Outdoor allergens
Chemical irritants
Tobacco smoke
Air pollution
Respiratory infections
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6
Q

Breifly explain the pathogenesis of athsma (7).

A

Allergens are taken up by APCs, which activate Th2 cells, which activate mast cells, which produce IgE.
Mast cells with IgE that bind the allergen release mediators of bronchospasm, mucus, and vascular leaks.

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7
Q

Define allergic athsma.

A

Airway obstruction due to chronic eosinophilic airway inflammation.

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8
Q

What happens to bronchial blood vessels with athsma and what does it result in (2)?

A

Blood vessels are leaky and dilated.

Results in airway mucosal oedema and swelling.

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9
Q

What happens to mucus production with athsma? What does this result in?

A

Hypersecretion. Results in the occlusion of the airway lumen.

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10
Q

Name the three key components of allergic athsma pathogenesis and whether they are well/poorly understood.

A

Induction phase - poorly understood, related to acquisition of allergy
Smooth muscle shortening - well understood
Inflammation - not completely understood

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11
Q

Name one way to prevent or reverse airway obstruction in athsma.

A

Treating the smooth muscle contraction which is relatively easy.

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12
Q

Describe one way to prevent or reverse airway inflammation.

A

Inflammation is partially sensitive to glucocorticoids (corticosteroids)

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13
Q

Name two relaxant agents of the airway smooth muscle.

A

Adrenaline

B2 adrenoceptor agonists

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14
Q

Name threeconstrictor agents of the airway smooth muscle.

A

Histamines
Leukotrienes
Acetylcholine

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15
Q

What is the main mechanism of action of B2 agonists in athsma treatment?

A

Relaxes smooth muscle cells by decreasing cytoplasmic Ca2+

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16
Q

Define SABAs, what kind of substance it is, what kind of treatment it is, whether it is fast or slow acting, and how long it lasts.

A
Short-acting B-adrenoceptor agonist
Is a reliever
Mainstay of acute bronchodilator therapy
Rapid action (2-5m)
Lasts 2-4h
17
Q

Name 3 adverse effects of SABAs.

A

Tremors
Palpations
Headache

18
Q

Explain drug delivery to the lungs.

A

Using an MDI, 10-20% is inhaled to the lungs and goes directly to systemic circulation.
80-90% is swallowed, and absorbed into the GI tract, going to the liver first.

19
Q

Define LABAs, what kind of treatment it is, what it must always be combined with, and an additional benefit over other treatment for athsma.

A

Long-acting B2-adrenoceptor agonists
Is a preventer
Always combined with a glucocorticoid
Has the benefit of chronic bronchodilation

20
Q

Describe briefly what happens in aspirin-induced athsma and what drug is used to treat it.

A

Overproduction of LTs

cysteinyl-leukotriene receptor antagonists are used.

21
Q

How do glucocorticoids prevent/reverse inflammation?

A

They decrease inflammatory gene expression

22
Q

Are glucocorticoids fast or slow acting?

A

Slow onset of action

23
Q

When are glucocorticoids used and how is it administered (2)?

A

Used as a first line therapy for prevention

Inhaled or taken orally

24
Q

Name four side effects of inhaled glucocorticoids.

A

Hoarseness
Weakness of voice (dysphonia)
Atrophy of vocal cords
Oral thrush

25
Q

How can the side effects of inhaled glucocorticoids be reduced?

A

Mouthwash

26
Q

What should be done with chronic use of oral glucocorticoids and to prevent what?

A

Taper dose to prevent withdrawal

27
Q

Name 4 side effects of oral glucocorticoids.

A

Hypertension
Weight gain
Diabetes
Osteoporosis